Bristol Bariatric Service (BBS) offers primary and revision bariatric surgery (including laparoscopic gastric band, gastric bypass and sleeve gastrectomy). We have an established unit since 2003 and have funding for approximately 250 primary operations per year.
Bariatric Surgery can be considered as a possible treatment option for people with obesity when:

• BMI >40 kg/m2 or person with BMI 35-40 kg/m2 who has other significant disease that could be improved if they lost weight (e.g. type 2 diabetes, hypertension, dyslipidaemia, obstructive sleep apnoea, Benign Intracranial Hypertension etc.).
• All appropriate non-surgical measures have been tried but the person has not achieved or maintained adequate, clinically beneficial weight loss.
• The person has been receiving or will receive intensive management in a Tier 3 service (WAMS).
• The person is generally fit for anaesthesia and surgery.
• The person commits to the need for long term follow up.
• Bariatric surgery is the option of choice (instead of lifestyle interventions or drug treatment) for adults with a BMI of > 50 kg/m2 when other interventions have not been effective.
• Patients with a BMI >35 kg/m2 who have recent-onset type 2 diabetes should be offered an expedited assessment for bariatric surgery as long as they are also receiving or will receive assessment in a Tier 3 service (WAMS).
• Consider an assessment for bariatric surgery for people with BMI 30-35 kg/m2 who have recent onset type 2 diabetes as long as they are also receiving or will receive assessment in a Tier 3 service (WAMS).
• Consider an assessment for bariatric surgery for people of Asian family origin who have recent onset type 2 diabetes at a lower BMI than other populations as long as they are also receiving or will receive assessment in a Tier 3 service (WAMS).

Download:

We will endeavour to assess, investigate and treat patients as soon as possible, and keep you fully informed of their progress.

We accept referrals from:

• Primary care via letter detailing BMI and co morbidities. 
• Interprovider

These should be sent to:

Pauline Clifford, Obesity Services Coordinator
Office 2, Gate 38, Level 3, Brunel building
Southmead Hospital, Westbury‐on‐Trym, Bristol. BS10 5NB
Telephone: 0117 414 0855 or 0117 414 0854

Advice & Guidance

Clinical Advice:
Bariatric Specialist Nurse, Faye Taylor
Telephone 0117 4147557 or 0755 7312784 (Monday-Friday).

Administration or Referral Advice:
Pauline Clifford
Email: pauline.clifford@nbt.nhs.uk (Monday to Wednesday) 
Telephone:0117 414 0855 or 0117 414 0854

Access to the services is by referral, preferably via the relevant specialist.

The Anaesthetic Department provides services at Southmead Hospital Bristol.

• All theatre sessions and emergency surgery

• Post-operative care, including the clinical care of patients in the Intensive Care Unit and High Dependency Unit

• Analgesia and anaesthesia for obstetrics (Southmead)

• Chronic pain management.

Booking team for Outpatients
Please refer via NHS eReferrals

General Manager
Karen Brown

Assistant General Manager
Niall Prosser

Support Managers
Laura Borg
Jack Brimson

Surgical Teams

Clinical Director
Ms Anne Pullyblank

General Surgery Consultants

Upper GI
Mr C Armstrong
Mr C Wong
Mr J Hewes plus Bariatric Surgery
Ms S Norton plus Bariatric surgery

Staff Grade
Mr N. Arvind

Secretaries for Upper GI team

Susan Sheffe
Telephone: 0117 4140834

Jo Miles
Telephone: 0114 4140837

Co-ordinators for Bariatric services

Pauline Clifford
Telephone: 0117 4140855

Diane Smith
Telephone: 0117 4140854

Lower GI (colorectal)

Mr A Roe
Mr A Dixon
Ms A Pullyblank
Ms A Lyons
Ms C Burt
Ms K. Mc Carthy

Secretaries for Lower GI
Yvonne James
Telephone: 0117 4140828

Jane Heaven
Telephone: 0117 4140835

Lindy Shoebottom
Telephone: 0117 4140838

Vascular surgery

Mr A Baker
Mr A Weale
Mr W Neary
Mr D Mitchell

Secretaries for Vascular surgery

Janice Davies
Telephone: 0117 4140841

Joan Barnard
Telephone: 0117 4140826

Endocrine and Transplant

Mr J Morgan
Ms A Edwards

Secretary for Endocrine 
Julie Clash
Telephone: 0117 4140825

Transplant and general surgery

Mr N Kadi

Secretary

Jo Miles
Telephone: 0117 4140837

Waiting list Co-Ordinators – Booking Team for “One Stop Hernia” Service

Liz hedges
Telephone: 0117 4148801

Sarah Crimp
Telephone: 0117 4148801

Do you work for a health or social care partner? You have access to the national core content of e-journals and database via the NHS Knowledge and Library Hub.

To access NHS e-resources online you will need to register for an OpenAthens account.

During staffed opening hours (Monday-Thursday 8am-4pm and Friday 8am-3pm) you are welcome to make use of the Library at Southmead Hospital, as a space for studying and using the print books for reference. You are welcome to bring you own laptop and use the WiFi available to all.

Contact us

For further details email us at southmead.library@nbt.nhs.uk.

The library at North Bristol NHS Trust is both a well-equipped and welcoming study space, and the ideal environment away from the workplace to catch-up on paperwork.

There are networked PCs, photocopying and printing facilities, as well as immediate access to our book and print journal collection.  Professional library staff are on hand with their expertise to help you get the most from the library’s resources.

• Networked PCs (access for North Bristol NHS Trust staff and students on placement at Southmead Hospital)
• Printing and photocopying facilities
• Study space
• Immediate access to library resources and expertise

E-resources

You will need an OpenAthens login to access these resources. To find out more and to register visit www.nice.org.uk/about/what-we-do/evidence-services/journals-and-databases/openathens (if registering from a non-trust computer, you will need to use your NHS email account).

Knowledge and Library Hub
Access to high quality knowledge and evidence resources in one place. Includes access to journals, books and e-books (including OUP handbooks).

DynaMed
Resource to support evidence-based clinical decision making

Royal Marsden Manual of Clinical Nursing Procedures
The leading resource for clinical skills and procedures

GMC Number: 3183115

Year of first qualification: 1987, University of Bristol

Specialty: Radiology

Clinical interest: Uroradiology and Interventional radiology

Secretary: Niamh Hamer

Telephone no: 01174149015

Dr Mark Julian Thornton is a consultant radiologist with interests in vascular, renal and urological imaging.

Dr Thornton is the lead Radiologist at North Bristol NHS Trust.

He is an Examiner for the Royal College of Radiologists, a Fellow of the Royal College of Physicians and a Fellow of the Royal College of Radiologists.

GMC Number: 4475237

Year of first qualification: 1985, Ain-Shams University, Cairo, Egypt

Specialty: Obstetrics and Fetal Medicine

Clinical interest: High risk pregnancies, women at risk of preterm labour, obstetrics ultrasound, prenatal diagnosis and management of fetal abnormalities, both diagnostic & therapeutic

Secretary: Jo Sirett

Telephone: 0117 414 7140

Mr Sherif Abdel-Fattah completed his MD thesis in Glasgow in 1994, undertook general Obstetrics & Gynaecology training in Yorkshire, then fetal medicine training in Bristol. He was Consultant at St Michael’s hospital in Bristol from 2002 before moving to Southmead Hospital in April 2008.

Mr Abdel-Fattah leads the UK training for overseas non-EU doctors in his role as the MTI (Medical Training Initiative) Officer for the Royal College of Obstetricians & Gynaecologists (RCOG). He also holds several national positions at the RCOG as he is member of the Global Health Unit, member of the Specialist Training committee, former member of the Part 2 MRCOG committee and of the DRCOG committee. He is Scientific Editor of the British Journal of Obstetrics & Gynaecology (BJOG).

Referral Criteria for Adult Burn Unit

The suggested minimum threshold for referral into specialised burn care services can be summarised as:

Size:

• All burns ≥3% in adults (Over 16 yrs)

Depth:

•  All full thickness burns

Site: 

• All burns to hands, feet, face, neck, perineum or genitalia
• All circumferential burns

Mechanism: 

• Any chemical or electrical burn
• Any cold injury
• Any burn where there is a suspicion of non-accidental injury or neglect

Co-morbidities:

• Any burn with concomitant medical illness, which may influence healing e.g. diabetes, paraplegia
• Any burn with concomitant trauma e.g. inhalation
• Any burn with concomitant psychiatric illness

Time: 

• Any burn not healed in 2 weeks

Other factors:

• Any unwell/febrile patient with a burn
• If burn wound changes in appearance / signs of infection or there are concerns regarding healing
• Any other burn that the referring department is not happy about or confident to manage

If the above criteria/threshold is not met then continue with local care and dressings as required. Burn injuries >25% TBSA + inhalation injury or >40% TBSA without will be referred and transferred to the local burn centre (Swansea).

If your referral needs immediate attention (e.g., life or limb threatening injuries), please call switchboard 0117 950 5050 - ask to speak to the Burns Consultant on call.

For non urgent referrals please submit MDSAS referral and then contact, SHO on-call via switchboard switchboard 0117 950 5050

Leave your contact number so the Burns service can advise you on the referral.

For Telemedicine for burns referral

Telemedicine for Burns Referral is available to all referring clinicians. For referral criteria see: Southwest Burn Care Network.

Burn Referral / Discussion Guideline How to refer to Bristol Adult Burns Unit MDSAS Telemedicine

Step one - assess the wound:

History

• Allergies.                
• Medications.                        
• Past medical History.          
• Last meal (time)        .
• Events/Environment related to injury.

Wound

• Inspect wound.
• First aid: cool running water for at least 20 minutes but keep patient warm.
• Use cling film as a temporary covering.

Burn injury

• Date and Time.
• Cause.
• Affected areas.
• Size.
• Depth.
• First aid measures.
• Other injuries.

Psychosocial

• Social concerns
• Safeguarding concerns
• Psychiatric history
• Substance Misuse History
• Next of Kin

Step two – Photograph

• Open webpage MDSAS NHS webpage and follow instructions.
• Remove all dressings.
• Download the Secure Image Data (SID) App from the App store or Android Store to take photos using a smart phone or tablet.
• Scan the QR code from the computer using the SID App on the phone.
• Follow the simple instructions to upload photos.
• Click to send referral and photo.

Step three – Referral discussion

If your referral needs immediate attention (e.g., life or limb threatening injuries), please call switchboard 0117 950 5050 - ask to speak to the Burns Consultant on call.

For non urgent referrals please submit MDSAS referral and then contact, SHO on-call via switchboard switchboard 0117 950 5050

For the SHO on-call, phone 0117 414 0978 to take non urgent referral calls.

Leave your contact number so the Burns service can advise you on the referral.

Telemedicine for burns referral

Telemedicine for Burns Referral is available to all referring clinicians.

For referral criteria see: Southwest Burn Care Network

Adult Burn Guidelines -  Management of the Burn Wound – First Aid

Aim:

• Stop the Burning Process
• Cool the Burn Wound

Stop the Burning Process:

• Remove patient from the source of injury.
• If on fire STOP, DROP, COVER face & ROLL
• Remove hot, scalding or charred clothing.
• Avoid self harm during above steps.

Cool the Burn Wound

• Cool burn with cold running tap water for at least 20 minutes
• Ideal water temperature for cooling is 15°C, range 8°C to 25°C
• Cooling is effective up to 3 hrs after injury
• Keep the remaining areas dry and warm to avoid hypothermia. If patient’s body temperature falls below 35°C - stop cooling.

NB

• Ice should not be used as it causes vasoconstriction and hypothermia. Ice can also cause burning when placed directly against the skin.
• Duration of running water should be at least 20 minutes unless other factors prevent this (eg. large burn causing rapid heat loss, hypothermia, and multiple traumas).
• Wet towels / pads are not efficient at cooling the burn as they do not cool the wound adequately. They should not be used unless there is no water readily available i.e. in transit to medical care. If required use 2 moistened towels/pads and alternate at 30 second intervals.
• Remove any jewellery or constrictive clothing as soon as possible.

Seek Medical Advice

For urgent referrals or if there is any doubt please discuss the case with a senior member of the burns medical team via Southmead Hospital Switchboard: 0117 9505050

For all burn wound injury and wound management advice please contact:

• Adult burns unit, Gate 33a, level 2 telephone: 0117 4143100 or 0117 4143102.
• Acute Burns Clinic telephone: 0117 4144005.
• Karen Highway Adult Burns Specialist Nurse Bleep 1380.
• Burns SHO on-call via switchboard.

Transfers

For transfers to the Burns Unit, remove all jewellery cover burn injury with cling film or clean dry sheet if evacuation is to occur quickly. Do not apply any creams or ointments. Be aware not too wrap the cling film too tight as this can cause a tourniquet effect if applied circumferentially and additionally restrict limb movement. Only if transfer is to be significantly delayed then the burn wound should be washed with chlorhexidine solution 0.1% or normal saline then more formal dressings should be applied. This should only be after liaison with the receiving burn service. If applicable, then simple application of non-adherent film, tulle/jelonet/gauze dressings to the burn wounds and wrap secondary dressings of gauze and crepes bandages loosely too allow for potential excess swelling. Elevate limbs if applicable. Keep patient warm (blanket, space blanket).

Chemical Burns

Remove contaminated clothing (store in a protective container for disposal later) and dry chemicals. Copious irrigation is required with tepid running water or saline as appropriate. Continued prolonged irrigation is required for all chemical burns for one hour or more until the patient’s chemical burning sensation has ceased/neutralised even if pH test strip is normal. Neutral = 7 or until transfer if appropriate. Bitumen and alkali burns require irrigation with water for an even longer period than other chemical burns. Hydrofluoric acid burns require neutralisation with calcium gluconate. Please discuss management with on-call burns team. Chemical eye injuries require copious water irrigation. Diphoterine is very helpful. Refer to ophthalmologist. Please bring chemical agent if available or provide details of the chemical agent. Contact the National Poisons Help line for advice.

Electrical burns

Relevant history may include loss of consciousness or cardiac symptoms such as chest pain or palpitations. A twelve-lead ECG should be undertaken. Cardiac monitoring is required within the first 24 hours period for significant injuries. Please discuss any episode further with the on-call burns team. Please note that all significant electrical injuries should be admitted to a burns service for definitive treatment.

Facial Burns

Clean with saline and apply soft paraffin to raw areas Apply soft paraffin to lips, clean eyes with saline, refer to ophthalmologist if required and apply eye drops or ointment as appropriate e.g. chloramphenicol ointment. Exclude injury-using fluorescein. Consider airway assessment and monitor for airway swelling, anaesthetic review if any concerns and discuss with on-call burns team.

Blisters (Burns only)

Small ones of 1 cm or less may be left intact, however, large ones and blister over joints will need to be de-roofed and dead skin trimmed away. Redress with non-adhesive dressings such as Mepitel, Adaptic Touch or hydrocolloid to small superficial wounds only. Do not wrap hydrocolloid dressings circumferentially around fingers but place in longitudinal strips.

Wound Care

Clean with saline, tepid tap water or shower patient (if applicable and stable).  If wounds are contaminated with dirt particles or infection suspected then warmed diluted 0.1% chlorhexidine solution (Savlon) should be used.

After Wound Assessment

Apply suitable low adherent dressing e.g. paraffin gauze (if daily dressings) or hydrocolloid dressing (if wound is superficial with low exudate).   If paraffin gauze is used, a secondary dressing of gauze and bandage is required.  Hydrocolloids can be used without a secondary dressing where there is little exudate (can be useful for fingers to facilitate movement).  If transferring a hand burn this can be temporarily placed in plastic bags to facilitate movement and comfort, depending on the extent of the burn. If delayed transfer or not transferring to the burns unit then hand burns and individual fingers will need to be redressed with a non-adhesive dressing such as Metipel or Adaptic Touch No ointment is used in bag. Do not use Flamazine or Flammercerium until seen by the burns surgeon, as these should not be used if the depth of the burn is unclear, as it will mask the appearance of the depth.

Tetanus

All patient’s tetanus status should be checked and revised protocol applied.

Please consult the Adult Burns Unit for additional Burns wound advice telephone: 0117 4143100 or 0117 4143102.

The death must be registered within 5 days.

In order to do this you will need the medical cause of death certificate issued by bereavement services and, if available, the deceased’s medical card.

The Registrar will ask for the following:

• Date and place of death.
• Full name and surname (and maiden surname if the deceased was a woman who has married).
• Date and place of birth (including town or village).
• Occupation (and if the deceased was a married woman or a widow the name and occupation of her husband).
• Deceased’s last known address.
• Whether the deceased was in receipt of a pension or public funds.
• If the deceased was married, the date of birth of the surviving widow or widower.

The Registrar will give you the following:

• Certificate of registration for the Department of Social Security.
• Green certificate for funeral director.

There will be a fee for each further copies of the registrations for banks, insurance etc., so you may need to take cash or a personal cheque.

Deaths occurring at Southmead Hospital Bristol must be registered by appointment at either of the following offices:

• The Regsitry Office, Southmead Hospital
  Monday – Friday 9.30am – 4pm
  Telephone:  0117 922 2800
   
• The Registry Office, The Old Council House, Corn Street, Bristol, BS1 1JG
  Monday, Tuesday, Thursday and Friday 9am – 4pm, Wednesday 10am – 4pm and 5pm – 7pm
  Telephone: 0117 922 2800